Uterine fibroids, also known as leiomyomas, are common non-cancerous growths that develop in or on the uterus. These benign tumors are composed of smooth muscle cells and fibrous connective tissue. They can vary significantly in size, ranging from as small as a seed to as large as a grapefruit or even larger. While fibroids are quite prevalent, not everyone who has them experiences symptoms.
How Fibroids Can Lead to Discomfort
Fibroids can cause discomfort by physically interacting with surrounding organs and affecting the uterus. For instance, subserosal fibroids, on the outer surface, can press against the bladder, leading to increased urinary frequency or a constant urge to urinate. If they press against the bowel, they can contribute to constipation or rectal pressure.
The physical bulk of larger fibroids can also stretch or distort the uterine cavity. Fibroids within the uterine wall (intramural) or bulging into the cavity (submucosal) can impact the uterus’s blood supply and function. These types may interfere with normal uterine muscle contraction, leading to heavier and more prolonged menstrual periods. In some cases, a fibroid may outgrow its blood supply, causing degeneration and acute, sharp pain.
Common Ways Fibroids Make You Feel Unwell
One of the most frequently reported symptoms of fibroids is heavy and prolonged menstrual bleeding, known as menorrhagia. This excessive bleeding can significantly impact daily life, sometimes requiring frequent changes of sanitary products. The prolonged blood loss can deplete the body’s iron stores, resulting in iron-deficiency anemia. Anemia can manifest as persistent fatigue, general weakness, a pale complexion, and shortness of breath, particularly during light physical activity.
Beyond bleeding, fibroids can cause pelvic pain or a feeling of pressure in the lower abdomen. This discomfort can range from a dull ache to sharp, localized pain, sometimes extending to the lower back or legs. Bladder and bowel issues are also common due to the pressure exerted by fibroids. These can include a frequent urge to urinate, difficulty completely emptying the bladder, or urinary incontinence. For the bowels, fibroids can lead to constipation, straining during bowel movements, or a feeling of incomplete evacuation.
What Makes Fibroid Symptoms Vary
The presence and severity of fibroid symptoms are influenced by their size, location within the uterus, and total number. Smaller fibroids, even if numerous, might not cause noticeable symptoms, while a single, strategically placed fibroid could lead to significant issues. Larger fibroids are more likely to exert pressure on surrounding organs, increasing the likelihood of symptoms like pelvic pressure or urinary frequency.
Submucosal fibroids, which grow into the uterine cavity, are strongly associated with heavy menstrual bleeding and related anemia, even if relatively small. In contrast, subserosal fibroids, located on the outer surface, are more likely to cause pressure symptoms or back pain rather than bleeding. The total number of fibroids can also contribute to symptom burden, as multiple fibroids might collectively occupy more space or disrupt uterine function.
Hormonal fluctuations, particularly levels of estrogen and progesterone, influence fibroid growth. These hormones can cause fibroids to enlarge, which can exacerbate existing symptoms or trigger new ones. During pregnancy, elevated hormone levels can sometimes lead to an increase in fibroid size and associated discomfort. After menopause, when hormone levels decline, fibroids often shrink, and symptoms tend to subside.
When to Seek Medical Advice
Consult a healthcare provider if you experience persistent or worsening pelvic pain that interferes with daily activities. Very heavy or prolonged menstrual periods, defined as bleeding for more than seven days or requiring frequent changes of sanitary products, warrant medical evaluation. Symptoms like unusual fatigue, weakness, dizziness, or shortness of breath should also prompt a visit to a doctor.
Any new or worsening bladder or bowel issues, such as increased urinary frequency, difficulty emptying the bladder, or persistent constipation, should be discussed with a healthcare professional. Significant changes in your menstrual pattern, including irregular periods or bleeding between cycles, are also reasons to seek medical advice.